Press items roundup

- TNR/McCaughey watch. As mentioned here numerous times, starting 14 years ago, The New Republic made Elizabeth McCaughey a public figure in 1994 and has been trying to mitigate the damage ever since. Concluding installment, under the circle-closing headline "No Exit" [also the title of McCaughey's original article], from Michelle Cottle here.

- Unknown gigantic cities watch. In my story last year about the surprisingly intense struggles within China to improve environmental protection, I mentioned a visit to Zibo, a coal-and-ceramics center in Shandong province. Zibo is one of countless cities in China that few outsiders have heard of but that are larger than, say, Chicago or Milan. The always interesting Moving Cities site, a Beijing-based effort to document urban design in fast growing cities, recently took a trip to Zibo to show what it looks like. Description and four photo essays about Zibo can be found here. (Note: for me, the Javascript on this site always stalled with Firefox. Worked OK with IE, Chrome, and Safari.)

Downtown view, with housing from the 1980s onward -- horizontal black bar is part of the site's convention for presenting photos: 
 

On the way into town:


Alley that I've walked down myself, with pre-1980s housing:



- Problems of the press watch. I am grateful to Jake Seliger, of The Story's Story site, for a retrospective of my 1996 book Breaking the News. He makes the discouraging but, I think, accurate point that the arguments and criticisms from back in that era are all truer now. I have thought several times about revising or updating the book but have held back for two reasons. One is the shark-like instinct that it's worth always moving ahead to new territory. The other, that the central points to make remain the same; the details would differ and be more depressing.

Update on McCaughey and tobacco

Yesterday I reported this exchange with a representative of the Manhattan institute, where Betsy McCaughey was based when she wrote her "No Exit" attack on the Clinton health reform plan:

 "I wrote back to Lindsay Craig asking which of these options the Manhattan Institute was saying:

"A: The Rolling Stone contention that tobacco companies collaborated with Ms. McCaughey and M.I. is totally false; there was no such contact or collaboration.

"B: We are confident that Ms. McCaughey's opinions were not influenced by tobacco companies, even though she may have worked with them.

"Her immediate response:
"A.   Betsy never worked with Phillip Morris." 

As a followup, I asked Ms. Craig whether there was any significance in the distinction between "tobacco companies" in the question and "Phillip Morris" in the answer. She said: No.  Her flat denial applies to "Tobacco companies (plural -- though the document in question is from Phillip Morris)."

Clear enough. So we now have documents, reported in Rolling Stone, in which a tobacco lobbyist claims in detail to have worked with McCaughey as she put together her articles -- and a categorical denial from the Manhattan Institute that she worked with tobacco firms. Yet again it would be helpful to have Ms. McCaughey address the specifics of the lobbyist's claim.

The obesity / class / region express rolls on

In response to a reader's comment that a pack of buffed-up CPAs "built like lumberjacks" took on construction workers and held their own, plus another about slimmed-down med students, this reponse:

"I agree with many of the observations from your med student correspondent. I work for a mid-sized management consulting firm comprised almost entirely of former Big Four consultants. We employee many CPAs and MBAs. Other people have different higher degrees. Though we have offices all over the Midwest as a group the employees are not merely trim but fit. Just in my office in Kansas City (traditionally considered one of the fattest cities around) we have several triatheletes, lots of marathon runners and long-distance cyclists. Having a personal trainer is not consider out of the ordinary.

"It is assumed that everyone has an athletic hobby. To be unfit would be a career-limiting trait. To be obsese would be career suicide. No one munches chips at their desks.

"Management consulting can be a bit of a macho world. Some guys compete, even place bets, when they participate in local charity runs. To lose is to invite gentle (or not so gentle) ribbing from other males. Our firm regularly competes in Corporate Challenge, which is taken quite seriously by the leadership. To win an event merits a mention at office-wide meetings.

"I think fitness is seen by the leadership as a proxy for discipline, self-control, and health. We are forbidden by HR from asking certain questions during interviews so questions about excercise and visual inspection of candidates can be used to gather important data about perspective hires. All things being equal, a big fat guy would not be hired.

"Most of us have to visit clients and it is believed that the appearence of fitness and vitality gives clients confidence in our skills, our ability to work long hours, our discipline.

"Not all of this is class. Many of the partners and employees, including myself, come from working class, rural or near-rural childhoods in small towns thoughout the Midwest or South. Some come from extremely small towns in western Kansas. A few were overweight or obese earlier in life and have worked hard to overcome that. I guess a lot of this is self-selection but I think most is a by-product of ambition and peer pressure. Somewhere along the way, we picked up the idea that to rise in the corporate world you had to have a certain look. This look includes being trim, having no facial hair, having enough muscle to fill out a suit but not so much you're conspicuous, and having nice teeth."

After the jump, a report based on compare-and-contrast observations in Kansas City and Chicago.
_____

Continue reading "The obesity / class / region express rolls on" »

Manhattan Institute replies (re McCaughey and tobacco lobby) UPDATED

In response to this item today, concerning Rolling Stone's claim that Betsy McCaughey worked secretly with tobacco lobbyists when preparing her 1994 New Republic article about the Clinton health reform plan, I have just received this note from Lindsay Craig of the Manhattan Institute:

"Below is a letter to the editor of Rolling Stone from Lawrence Mone, president, Manhattan Institute for Policy Research.

"In his article "The Lie Machine," Tim Dickenson asserts that former Manhattan Institute scholar Betsy McCaughey's work was influenced by Phillip Morris.  This conclusion is false.  Betsy McCaughey wrote two articles for the Wall Street Journal on the Clinton Health Care plan and an additional article for the New Republic which was solicited by its publisher.  At no time were her ideas influenced or controlled by anyone but the author herself."

I have written back to Lindsay Craig asking for clarification on what, exactly, Mr. Mone is saying. The Rolling Stone documents say that Ms. McCaughey worked, in secret, with tobacco company lobbyists in preparing her articles. Mr. Mone's statement says that she was not "influenced or controlled" by anyone else. I have written to ask whether Mr. Mone is saying that she never worked with tobacco representatives (whether or not she was "controlled" by them); and whether the Manhattan Institute was aware of any such collaboration. More info as it arrives.

UPDATE:
 I wrote back to Lindsay Craig asking which of these options the Manhattan Institute was saying:

"A: The Rolling Stone contention that tobacco companies collaborated with Ms. McCaughey and M.I. is totally false; there was no such contact or collaboration.

"B: We are confident that Ms. McCaughey's opinions were not influenced by tobacco companies, even though she may have worked with them.

Her immediate response:

"A.   Betsy never worked with Phillip Morris." 

Is this a question of a lobbyist grossly exaggerating his "influence" to impress bosses and funders? That's a very familiar pattern in Washington. On the other hand, the lobbyist's detailed knowledge of Betsy McCaughey's writing plans suggests some interaction. I don't know the underlying truth here. It would be valuable if Ms. McCaughey, who has specialized in detailed textual analysis, would address in specific what these documents contend.

One crucial B. McCaughey update

I have deliberately laid off the Betsy McCaughey theme for the past month-plus. I had my say; she continues to have hers; people can make up their minds.

But revelations late last week by Tim Dickinson, of Rolling Stone, are at face value so important that they deserve to be underscored. It's worth reading Dickinson's whole dispatch and studying the on-line scans of the documents he has found. But to me the real news is the evidence that tobacco lobbyists secretly worked with McCaughey to prepare her infamous 1994 New Republic article "No Exit." 

As I argued back in 1995 in "A Triumph of Misinformation," everything about McCaughey's role in the debate depended on her pose as a scrupulous, impartial, independent scholar who, after leafing through the endless pages of the Clinton health proposals, had been shocked by what she found. If it had been known at the time that she was secretly collaborating with one of the main interest-group enemies of the plan, perhaps the article would never had been published; at a minimum, her standing to speak would have been different.

(For the record: Yes, I am aware that my friend and current Atlantic colleague Andrew Sullivan, who was then TNR's editor, is the one who decided to publish this article. In the 15 years since the article's appearance, the magazine and its writers have, to their credit, repeatedly pointed out its errors and apologized for spreading its misinformation. Mickey Kaus was doing so immediately after the article's embarrassing selection for a National Magazine Award for "Excellence in Public Interest." Jonathan Cohn, author of the indispensable book Sick, did so early this year. The TNR site has a "link" to the original McCaughey piece, but it's not connected to the article itself.)
 
Now Tim Dickinson produces documents from a tobacco lobbyist about his efforts to derail the Clinton health bill, including this one involving McCaughey and her then employer, the Manhattan Institute:
 

In case that's blurry, here is what Dickinson says:

"What has not been reported until now is that McCaughey's writing was influenced by Philip Morris, the world's largest tobacco company, as part of a secret campaign to scuttle Clinton's health care reform. (The measure would have been funded by a huge increase in tobacco taxes.) In an internal company memo from March 1994, the tobacco giant detailed its strategy to derail Hillarycare through an alliance with conservative think tanks, front groups and media outlets. Integral to the company's strategy, the memo observed, was an effort to "work on the development of favorable pieces" with "friendly contacts in the media." The memo, prepared by a Philip Morris executive, mentions only one author by name:

' "Worked off-the-record with Manhattan and writer Betsy McCaughey as part of the input to the three-part exposé in The New Republic on what the Clinton plan means to you. The first part detailed specifics of the plan." '

"McCaughey did not respond to Rolling Stone's request for an interview."

Maybe there is another side to this story, but if unrebutted it is damning.

Once again, a first-rate speech

I don't know how many people stayed tuned in to watch the whole hour-plus of this speech, counting intro and so on. But, once again among his major addresses, it will bear long-term study for its range, tone, and clarity:

 - Conciliatory: You Republicans want to talk about tort reform? Let's hear your ideas.
 - Tough: When you tell lies, we will call you out.
 - Clarifying: For the first time ever, I felt as if I glimpsed a "larger idea" behind the Obama plan.
 - Big picture: The role-of-government soliloquy at the end, including the connection to the moral and social-contract histories of Social Security and Medicare.
 - Emotional, sans schmaltz: As he got ready for the end, I feared that he would tell the story of all the Lenny Skutnik figures in the First Lady's box. Instead, he told Ted Kennedy's story, with allusions only to Kennedy's Republican friends.
- Simple performance dynamics: Well delivered, including at crucial points talking over the applause to keep the rhythm going.
- Manners: Will it pay off for the Republicans to have booed him and, in the case of Rep. "Gentleman Joe" Wilson of South Carolina, to have yelled "you lie!" at the President? We'll see. Update: An ActBlue site supporting an opponent to Wilson raised more than $25,000 within three hours of his outburst. Via Simon Owens.

There will come a time when Barack Obama cannot pull himself out of pinch with a big speech. And obviously we don't know how this debate will turn out yet. But he hasn't fallen short on the big-speech front yet. More tomorrow.

Three updates: Hudson River, "false claims," origins of Iraq

Catching up on a variety of previous reports:

1) The FAA responds in a sensible, proportionate way to last month's tragic crash above the Hudson River. Following the lead of the NTSB, as mentioned here, it will soon propose clear, common-sense rules of the "road" to keep airplanes and helicopters safely separated in the busy Hudson River corridor. For instance, it will require -- rather than just expect -- that northbound traffic stay on the east side of the river, and southbound on the right; and that helicopters stay at a lower altitude than the airplanes; and all pilots stick to the same radio frequency; and other steps.

Why this matters: because it's a targeted, non-panicky response directed at the specific problem that has been revealed, rather than a sweeping exercise in TSA-style "security theater." It will no doubt create complications of its own, mainly through increased work for controllers. But overall, this is a victory for common sense.

2) Jim Rutenberg of the New York Times, whose previous reporting about the health-care debate has been noted (in different ways) here and here, has a very strong story today about Elizabeth McCaughey and her role in these discussions.

Why this matters: the story straightforwardly does something that goes against the nature of mainstream coverage. It notes the influence that Ms. McCaughey's claims have had on public discussion, while also flatly saying that those claims are often false. It's worth recognizing what a step this is for the Times, prefigured in this story from three weeks ago. The natural reflex of mainstream publications is to finesse such disagreements with the "some critics claim..." approach. It seems more "objective," and it certainly is safer for the reporter and the news organization. And when we are talking about differences of opinion, judgment, or political creed, of course that's exactly the right approach to take. ("Is the Administration's approach to Iran likely to work? Some critics claim...") But there is a such a thing as plain misstatement of fact, and it is good when the press can point it out.

3) James Gibney of the Atlantic also has a very strong, short item about revisionism now being practiced by some of the architects and enthusiasts of the invasion of Iraq.  In particular, the writer Max Boot and the former DOD official Paul Wolfowitz, the latter of whom I have written about here and here.

Why this matters: The edge to Gibney's argument will be evident to anyone who reads it. What most people would not realize is how particularly trenchant a judgment this is, coming from him. As a one-time Foreign Service officer (and former executive editor of Foreign Policy magazine), James Gibney is no one's idea of a hothead. He is more gentlemanly than most people who express views on this site (not to mention on the whole untrammeled web), and less known for harsh opinions. These words have weight.

A very simple question about the 'public option'

No one I have ever met who is eligible for Medicare would dream of turning down its coverage.

And therefore the "public option" would be so terrible because.... ???
____
Medicare is of course a "public option" in spades. I remember the debates before its enactment in the 1960s, about how the coming of "socialized medicine" would be the end of the American way.

Of course now we have a system that is taken for granted as a central part of the American way. Yes, yes, I am aware of the arguments (as laid out here, here, and elsewhere) about the distortions and cost pressures within Medicare. Still: as a matter of politics I have always thought that the route toward health-coverage reform in America would be steady expansion of the eligibility standards for Medicare. First down to age 60, then 55, then... 

I know that "logic" tells us only so much about health policy debates. But, seriously, how can people with a sound mind and a straight face take Medicare as part of the landscape but consider the "public option" an abomination? Just curious -- but genuinely curious.

Will it never end? McCaughey v. Ezekiel Emanuel

Dr. Ezekiel Emanuel should need no introduction to Atlantic readers. Among his many pursuits is writing a number of interesting articles for our "Food Channel," under Corby Kummer's auspices. He should need no introduction to anybody, since over the past decade-plus he has so often been involved in deliberations about the right future health-care path for America and the world. I stress "the world" since he has traveled widely and emphasized public-health challenges for poor nations too. I know him slightly -- just well enough that, a few weeks ago, I asked his journalistic advice for contacts in China on a public-health story I'm working on. He is an oncologist and bioethicist -- and, of course, older brother of Rahm Emanuel from the White House.

Elizabeth "Betsy" McCaughey also needs no introduction to Atlantic readers. She has brought more misinformation, more often, more destructively into America's consideration of health-policy issues than any other individual. She has no concept of "truth" or "accuracy" in the normal senses of those terms, as demonstrated last week when she went on The Daily Show. Virtually every statement she has made about health-reform proposals, from the Clinton era until now, has been proven to be false. It doesn't slow her down.

And now we have the New York Times, in a big take-out story, saying that Dr. Emanuel, in his role as Obama health-care advisor, is in an "uncomfortable place" because he is being criticized by*:

1) Betsy McCaughey !
2) Rep. Michele Bachman (look her up) !!
3) Sarah Palin !!!
4) Lyndon LaRouche !!!!

McCaughey, Bachman, Palin, LaRouche -- shaping American debate and media coverage about health policy? Was Zsa Zsa Gabor not available?

To be "fair," the story puts the criticisms in "context," thus:

"Largely quoting his past writings out of context this summer, Betsy McCaughey, a former lieutenant governor of New York, labeled Dr. Emanuel a "deadly doctor" who believes health care should be "reserved for the nondisabled" -- a false assertion that Representative Michele Bachmann, Republican of Minnesota, repeated on the House floor."

"Out of context" and "false" are useful caveats. But why is the story about Ezekiel Emanuel being on the hot seat in the first place -- and not about the campaign of flat lies by McCaughey, Bachman, Palin, and LaRouche? Why are real newspapers quoting what they say any more? (Interestingly, LaRouche's claims rarely get NYT coverage. In in this case, he is apparently "legitimized" by ... McCaughey.) If I start a campaign of lies against somebody and get Soupy Sales plus Lynette "Squeaky" Fromme to agree with me, can I expect them to be regularly publicized in the mainstream press?

I do understand - and wrote before -- about how difficult it is for the mainstream press to decide that one party to a controversy is making things up, doesn't care about facts,  and will keep saying whatever it wants. I also recognize that when a campaign of falsehoods has a political effect, the effect itself can be worth writing about. But does it have to be presented in a way that suggests that the McCaughey-Bachman-Palin-LaRouche team is just another participant in political discussion? This can give "fairness" a bad name.
___
* Here are paragraphs two and three of the story -- the "nut graf" passage establishing that there is a controversy:

"Largely quoting his past writings out of context this summer, Betsy McCaughey, a former lieutenant governor of New York, labeled Dr. Emanuel a "deadly doctor" who believes health care should be "reserved for the nondisabled" -- a false assertion that Representative Michele Bachmann, Republican of Minnesota, repeated on the House floor.

"Former Gov. Sarah Palin of Alaska has asserted that Dr. Emanuel's "Orwellian" approach to health care would "refuse to allocate medical resources to the elderly, the infirm and the disabled who have less economic potential," accusations similarly made by the political provocateur Lyndon H. LaRouche Jr."

Today's McCaughey, euthanasia, and general falsehood update

Several more objections, clarifications, and additional bits of evidence following the much-bruited -- and to me somewhat anticlimactic -- Betsy McCaughey-Jon Stewart smackdown two days ago. (Previous reactions here.)

On the origins of Betsy McCaughey's argumentative style:
A reader suggests they have one obvious source:


The reader explains:

Cleese's character is armed with all that one could ask for: keen wit, boundless vocabulary, perfect presence of mind, and all the facts on his side. And yet, even he can be played to a draw by a liar who maintains a sufficiently unshakable facade of conviction.

On the details of why "death panels" are so preposterous
A reader in Maine writes:

Another absurdity in the argument of Betsy McCaughey is her claim that there is something wrong with doctors having to follow a patient's wishes as expressed in a living will.  There are two major problems here: 1) People can always change their living will, just as they can change their will at any point.  The later living will supercedes the later one. So if a person makes a living will when healthy and sees things differently when ill, the sick person can express different wishes in the new living will.  2) Why shouldn't doctors have to respect people's wishes on end-of-life care? I have heard countless stories of living wills being ignored.  The provision on living wills is effectively an implementation provision, providing for accountability and for the wishes of the patient to be respected.

Further on the Living Will point:
Reader Zach writes:

I'm surprised you didn't mention this.  McCaughy's twisted logic is basically that after you draft a living will it will be enforced ruthlessly by doctors seeking to up their quality rating even if you personally object.  Backing her up is an anecdote about her apparently hearing a woman telling her to hurry up and help as a doctor suffocated her with a pillow or something.  Her point is that, by rewarding adherence, we're making doctors stick with the patient's initial stated intent.  However, if you're conscious you can amend, annul, or otherwise do whatever you want with your will, living or otherwise, at any time you want.  If you're conscious enough to tell someone not to pull the plug, you haven't triggered your living will yet.

Continue reading "Today's McCaughey, euthanasia, and general falsehood update" »

Revisiting McCaughey-v-Stewart

As I mentioned this morning, I thought Betsy McCaughey was even more blithely disconnected from the world of reality than I had expected -- but that she was weirdly "effective" against Jon Stewart, since there was no way to shame her by pointing out that what she said was untrue. She would just smile, mug at the audience in an "isn't he cute!" way, and say, No, I'm right.

Not all readers agreed. Below and after the jump, a sample of dissenting views, with brief retort at the end.

Objection 1: The Audience Is In on the Joke

...I disagree that talking over Jon Stewart the way people do in appearances on Fox News is an effective tactic for the guest. It might be better than some of the other options, but it backfires for a weird reason, one that might be harder to see if you don't watch the show regularly.



From its inception in 1997, the distinguishing shtick that makes the show unique is a type of edited interview segment in which the show's "reporters" interview obscure and completely crazy people. The subjects have received some local press attention for doing something bizarre and they're desperate for media attention. The reporters pretend to be mainstream press rather than comedians, and they use a deadpan style that allows the interviewees to provide most of the humor. What struck me about the McCaughey interview, and the recent interview of Orly Taitz by Stephen Colbert, was that Stewart and Colbert are clearly adapting the "crazy person" interview techniques to their live in-studio host interviews with guests that don't agree with them.



The normal host interviews vary a lot but they are always a two-way conversation with some socially well-adjusted give and take. In these two recent interviews, as the guest acts more unstoppable and enthusiastic unhinged when discussing "their" topic, the interview slides into the familiar "crazy person" style. That's a cue for the show's regular audience to frame the discussion and the interviewee in a very different way.


Objection 2: It Worked for Betsy, but It Won't Work for Others

I expect you are very right about this being an interview that will be studied by right wing operatives for some time to come. However, I feel like you overlooked a couple important pieces which may make this scenario unrepeatable (particularly if those at the Daily Show are paying attention).

Continue reading "Revisiting McCaughey-v-Stewart" »

McCaughey on the Daily Show

Well, my TV-owning neighbors were all away last night, so I couldn't watch the McCaughey-Stewart showdown by peering through their windows and had to see it just now on the web. Clips below, starting with the first segment of the interview as broadcast. Three conclusions:

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Betsy McCaughey Pt. 1
www.thedailyshow.com
Daily Show Full Episodes Political Humor Healthcare Protests

Conclusion one: I have been far too soft on Betsy McCaughey. Even when conferring on her the title of "most destructive effect on public discourse by a single person" for the 1990s. She is way less responsible and tethered to the world of "normal" facts and discourse than I had imagined.

Conclusion two: The exchange is significant, because it demonstrates that there is indeed a way to "handle" Jon Stewart. You simply have to ignore what he says, interrupt and talk over him, and keep asserting that you're right. You even can try to usurp his role as host by mugging at the audience and rolling your eyes in a shared "there he goes again!" joke with the viewers.

In retrospect, this is the crucial weakness that in their different ways both Bill Kristol and Jim Cramer revealed in their appearances on the show. They listened to Stewart and -- even Kristol!!?! -- revealed through their bearing that they recognized there was such a thing as being caught in an inconsistency or presented with an inconvenient fact. McCaughey did none of that. She is just making it up, as anyone who has followed her work over the decades will know. She was not even minimally prepared for her appearance on the show, flipping aimlessly through the giant briefing book (of legislative clauses) she brought on stage. But  she didn't let it bother her. The exchange demonstrated that if the guest reveals no self-awareness or does not accept the premise of factual challenge, Stewart can't get in his normal licks. Future guests will study this show.

Conclusion three: A good point Stewart made, albeit not registered by McCaughey, concerns the unbelievable inconsistency of attention to "incentives" built into health care systems, today's and tomorrow's.

That is: when McCaughey admits that there is no literal "death panel" provision in the new health care provision, she goes on to say something similar to what other conservatives, most recently Charles Krauthammer in the Washington Post today, contend: that the very act of reimbursing doctors for a  discussion about "living wills" and end-of-life care will have a subtle bias in favor of an euthanasia-like outcome.

On the merits of this claim, I vehemently disagree. Having had, along with my siblings, first-hand, extended, and very painful experience with this process during my own father's decline and death last year, I would put reimbursement schemes for living-will discussions at the very bottom of the list of factors that make such decisions so wrenching for everyone involved.

But let's assume I'm wrong (though you'll never convince me of that) -- and that there is some third-order ripple-effect bias that comes from paying doctors for these every-five-year discussions. Why is the potential skewing effect of that payment the only thing we notice -- and not the thousand other life-and-death, rationing-and-queuing incentives that are built into every detail of the medical system now? And that David Goldhill -- no supporter of the Obama plan -- goes into so thoroughly in his cover story in this month's magazine? Yesterday I spent more than an hour on the customer "service" line for my own health insurance company, trying to get the answer to a simple "is this covered?" question. At the end of the hour, when I'd reached the queue to talk to a human agent, I got this recording: "Due to circumstances beyond our control, your call cannot be completed at this time. Please call again later." This has a kind of rationing/skewed incentive effect of its own -- even for someone fortunate, like me, to have good health insurance coverage. So, yes: I will listen to arguments about the hypothetical, subtle, psychological biasing effect of encouraging discussions about end-of-life decisions -- but only if they're in the context of the far more blatant, perverse, and destructive incentives built into today's system.

But see for yourself.

Second part of McCaughey's interview as broadcast.

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Betsy McCaughey Pt. 2
www.thedailyshow.com
Daily Show Full Episodes Political Humor Healthcare Protests

Extended interview, with outtakes, part 1, is here; extended interview part 2 is here.

Tonight on the Daily Show: McCaughey v Stewart!

Now I'm sorry I still don't have a TV. Elizabeth "Betsy" McCaughey, whose role in public life I have so often marveled at, has agreed to go on the Daily Show this evening.

Anything is possible, and perhaps Jon Stewart will for once fall down on the job as an interrogator. But at face value you have to wonder: has she ever seen the show? Perhaps the episode with James Cramer?

Maybe I'll go stand outside a neighbor's window this evening and listen real carefully. (And yes, yes, I know I can see it on the web not long afterwards.) Talk about must-see TV; this is it.

One more on the selling of "death panels"

A reader writes:

"I'm not sure if it has been pointed out yet, but the whole "Death Panel" bullshit is especially ironic given that the ability of insurance companies to grant/deny access to healthcare is effectively a death panel. Can't afford a plan? Tough luck. Not eligible for whatever reason? Tough luck."

This illustrates the biggest change in the rhetoric of health care reform over the past year. Last summer, during the campaign, Obama succeeded in focusing attention on the real problems of the patchwork insurance-and-care system as it actually exists: rising costs, bureaucratic inflexibility, perverse incentives, inevitable delays and de facto rationing, implicit decisions about life and death. Now, various opponents of a reform plan have succeeded in shifting attention to the imagined problems of a post-reform system: rising costs, bureaucratic inflexibility, perverse incentives, inevitable delays and de facto rationing, implicit decisions about life and death. It is an achievement to ponder.
 

Why the "death panel" claim is working

In this recent item about the apparent triumph of the McCaughey/Palin/Grassley/ Limbaugh tribe in keeping the false "death panel" idea going, I said I had been wrong to think that the modern blogosphere could act as a truth squad. Here are several reader hypotheses about why things are panning out this way, starting with the one that's most vivid and convincing and ending with a truly constructive suggestion.

Theory #1: Triumph of the 'Sticky' Image

Your last blog post sure was depressing: not that you could be wrong, but that the new media ecosystem still doesn't have the tools to keep lunacies like McCaughey's "death panels" from becoming part of the political debate.

That said, if you're familiar with Chip & Dan Heath's book "Made To Stick" (www.madetostick.com), you can see that the death panel idea is probably too "sticky" to be debunked, defused, and delegitimized.  In their view, the six key principles behind sticky ideas (like the NYC sewer alligators, or the kidney thieves that drug you and leave you in an ice-filled bathtub [or boiled frogs, JF note]) are:

- simplicity
- unexpectedness
- concreteness
- credibility
- emotions
- stories

The death panel story contains virtually all of these elements.  It's a simple, concrete concept that anyone can picture.  It's certainly unexpected, it stirs emotions, and it's easy to tell -- or make up -- stories.  (My grandma has Parkinson's, and I won't have a government bureaucrat telling me she's got to die!") 

It's true that to a rational, dispassionate listener the idea of a death panel does strain the bounds of credibility.  However, the complexity of health care reform, the sheer size of the legislation, and the history of bizarre government policies that have been twisted by special interests, does leave room in the imagination for, well, the incredible.

So, to your point: does the new media ecosystem have a greater ability to stop charlatans?  Clearly yes.  But I wonder if any ecosystem could have stopped such a "sticky" idea.

Other theories after the jump, plus somebody who embraces the whole idea.
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Continue reading "Why the "death panel" claim is working" »

The NYT says "false." Good.

When writing the previous item yesterday afternoon, about the pernicious works and thoughts of Elizabeth McCaughey, I had no idea that the NYT was planning to go into the same terrain with a very good story today:

But I mention the story mainly because of the way it is presented as a lead item on the TImes's web site, as shown at left. Using the word "False" is a big - and important -- step for an organization like the Times to make. I can't recall a time when the NYT used that word in a headline to describe the "birther" worldview.

I was wrong

Twice recently I've done brief interviews on NPR's On The Media show. Both times have concerned the pernicious influence of one Elizabeth "Betsy" McCaughey, below.

In the early 1990s McCaughey single-handedly did a phenomenal amount to distort discussion of health-care policy and derail the Clinton health bill. She did so through an entirely fictitious argument about what the bill would do. You can go back in the records here, here, and here, but the issue boils down to this: She claimed that the bill would make it illegal to go outside the government plan for coverage or pay doctors on your own. If a doctor took money for such outside-the-system services, she said, the doctor could go to jail. That was a flat-out lie. (One of the very first clauses of the legislation said, "Nothing in this Act shall be construed as prohibiting the following: (1) An individual from purchasing any health care services.") But her imaginary "no exit" claim was repeated so often by so many "respectable" media sources that it effectively became "true" and played a large part in stopping the bill. It would be as if the "birthers" had persuaded John Roberts to say, "Wait a minute, let's take another look at that birth certificate" and decline to swear in Obama on inauguration day.

McCaughey has been at it again this year -- twice, in fact. First was with an early, equally false claim that to compile  "comparative effectiveness" data about medical care -- which drugs had which effects, which surgical procedures led to which results, the sort of data collected routinely about education, air safety, and everything else -- would lead to a Big Brotherish intrusion on individual medical decisions. That one seemed to get knocked out of contention fairly early. Then she was back with the "death panels" argument. And here is where I made my mistake.

In the On the Media interviews, I said that the "media ecosystem" was a lot different now from what it had been fifteen years ago. Back then, there was no blog world. The news cycle moved in days-long or weeks-long intervals, as newspapers came out each morning and newsmagazines each week. It was very hard to have instant feedback or correction in real time, so false stories could solidify before the truth squad had a chance. The early McCaughey was brilliantly matched to this system. Her unvarying pose is that of the objective researcher who has, selflessly, pored through the pages of a bill and emerged to warn us about what she has found. People took it at face value the first time.

But these days, I said, that wouldn't work as well. She personally now had a track record. (Republican politician with a turbulent history; proven distorter of the facts.) And thousands of other people could now look through a bill too and post their findings mere minutes or hours after her claim. Thanks to blogs, Wikis, and the rest, there was a more nimble check-and-balance built into the discussion of ideas these days. And indeed it seemed to work that way early this year, with her failed "comparative effectiveness" foray. She made a claim; "crowdsourcing" proved her wrong; she piped down. And so, I confidently said to Bob Garfield of OTM, we'd seen a good side of today's Web-based decentralized journalism. There were plenty of bad sides, but the new potential to stop charlatans was a plus.

But then came her claim about the "death panels." About the plain old facts here, there is as little room for rational dispute as with her previous phony contentions. The bill would not call people before panels to determine whether they had a right to live. Details from the conservative Republican Southerner who sponsored the plan, here.

Beyond the facts, anyone who has had first-hand experience with modern end-of-life issues knows this is not something to demagogue. The combination of what is eternal, namely man's mortality, and what is new, namely the frontiers of high-tech medicine, converts what has always been a painful, fraught, and central aspect of human existence into something with even more painful dilemmas and choices than in previous days. Seriously: I do not think that any decent person who has seen this process, up close, can imagine preaching to anyone else about the choices and consequences. It's just too complicated and painful. And certainly any fair reading of the legislation indicated that it was designed to give individuals and their families more rather than less control over what are inevitably impossible choices about our loved ones and ourselves -- to reduce the chances that anyone else could preach or dictate to them.

But the flow of argument makes it appear that "death panel" has won the battle of political ideas, as "no exit" did 15 years ago (and as the "birthers" have not done). For example, Charles Grassley seems to have bought it. I don't know which interpretation is more depressing: that Grassley actually believes in death panels (ie, he's irrational), or that he knows better but figures it's smart to say he believes (ie, he's craven). The political fundamentals, as I understand them, still favor the passage of some health-care bill. To that extent, Ms. McCaughey may indeed have been blunted. But I said two weeks ago that I thought today's communications systems had caught up with people who invented facts. I was wrong.

In my, umm, mature years, I don't generally see a point in going after people personally. I have enough adversaries already. But there are necessary exceptions. And the ability to have a civil discussion about central policy issues, in terms that are connected to the world of facts and realities, matters for reasons that go beyond any one person's involvement.

Three news updates: GDP, airplanes, health politics

1. GDP department: The NYT yesterday had a very good, double-length op-ed about the folly of relying strictly on GDP and its growth as a proxy for human happiness, social progress, or overall national success. (Simple illustration: home security systems add to national economic activity, but the need for them may illustrate a decline in real human happiness and wellbeing.) Back in 1995, the Atlantic had a very good cover story to very similar effect. I don't know whether it's discouraging that the same case has to be made again and again or encouraging to see similar logic being applied. But if you were interested in the NYT piece, the Atlantic one (by Clifford Cobb, Ted Halstead, and Jonathan Rowe) is a worthy  complement.

2. Airplane department: I mentioned shortly after the tragic Hudson River aerial crash that a person who had never driven cars - let's say an Amish farmer -- might look at traffic on a busy roadway and think: how do they keep from hitting each other?!? How can it possibly be safe? Similarly, people with no experience in airplanes might look at areas like the Hudson River "VFR corridor" and think: how do they keep from hitting each other?!? How can it possibly be safe?

If you would like to hear how this perspective sounds when applied in a news broadcast, there was a specimen on NPR's (of course generally admirable) All Things Considered this evening,  here. Contrary to general assumption (and the specific assumption of this segment), air traffic controllers are not what keep airplanes from running into each other. William Langewiesche, a long-time pilot and son of a revered aviation writer, explained this point in the Atlantic in a story about controllers several years ago. In brief: "controlled" flight is crucial when airplanes are in clouds or when for other reasons the pilots can't see where they're going; and when flights are being sluiced and sequenced into busy airports. It's also mandatory for all flights at the altitudes where jets fly. But otherwise, the pilots are the ones keeping their planes from hitting each other, as car drivers and boat skippers do. This crash was a tragedy that should be studied, but not from the perspective of a person on a buggy who views a collision as a sign that roads are inherently unsafe. (Minor factual-error complaint after the jump.*)

3. Health department: In response to this item yesterday, I have received abundant correspondence to the effect of: especially after you've come back from China, how can you possibly be against free debate? It would be so wrong to ram a bill right down the throat of an unprepared Congress and public.

Yes, yes, we're all in favor of free debate. But organized efforts to shout down public officials at "town meetings" are not my idea of what Thomas Paine, John Peter Zenger, Socrates, and the rest were trying to promote. Nor is propagation of demonstrably false information, including the "death panel" scare that has most effectively been debunked by a conservative Republican Senator from Georgia.

Below and after the jump, a note from a reader who has "genuine" concerns about the Obama plan but is worried that irrational "birther"-style opposition will keep the serious concerns from being aired. I don't agree with all of his concerns, as noted below; but I think his analysis of the politics is right:

I completely agree with the observations you and [Steven] Pearlstein make about the Republican positioning on the health care debate.  I also agree with Steven's statement  that "Health reform is a test of whether this country can function once again as a civil society -- whether we can trust ourselves to embrace the big, important changes that require everyone to give up something in order to make everyone better off."  However, that does not translate into automatic agreement on the plan as proposed--a presumption that the advocates of the current health care bill would have us accept as true.

Continue reading "Three news updates: GDP, airplanes, health politics" »

Let's mark this moment in the health debate as it happens

Nearly fifteen years ago, after the collapse of the Clinton health-reform effort, I spent a lot of time working on an Atlantic article (and subsequent book chapter) about how, exactly, the discussion of the bill had become so unmoored from reality and finally determined by slogans, stereotypes, and flat-out lies.

It's better to do that after the fact than not to do it at all. And, if I do say so, I think the article remains useful background reading for what's going on now -- including the return-guest-star role of the voluble but consistently misinformed Elizabeth "Betsy" McCaughey.

But if there's a chance, it would obviously be better still to keep the current debate from ending up in the same intellectual/political swamp in which the previous one drowned. That is why I was so impressed by this Steven Pearlstein column two days ago in the Washington Post. (Yes, despite changes noted recently in the WaPo, there are good people doing good work there.) Pearlstein, a longtime business and financial columnist and reporter (and last year's Pulitzer winner for commentary), is no one's idea of a predictable leftie. Thus when he says things like the following, they have weight:

The recent attacks by Republican leaders and their ideological fellow-travelers on the effort to reform the health-care system have been so misleading, so disingenuous, that they could only spring from a cynical effort to gain partisan political advantage. By poisoning the political well, they've given up any pretense of being the loyal opposition. They've become political terrorists, willing to say or do anything to prevent the country from reaching a consensus on one of its most serious domestic problems....

He goes through the most familiar talk show / Republican Caucus / Sarah Palin / protest group complaints -- "death committees," socialized medicine, end of innovation, "keep the government out of my Medicare," etc -- and shows how, as with all of McCaughey's complaints over the years, they're just not true. The current legislation has defects, but they're not the ones most often yelled about. Then he makes the point that, to me, matters even more than the legislation itself.

Health reform is a test of whether this country can function once again as a civil society -- whether we can trust ourselves to embrace the big, important changes that require everyone to give up something in order to make everyone better off. Republican leaders are eager to see us fail that test. We need to show them that no matter how many lies they tell or how many scare tactics they concoct, Americans will come together and get this done.

Pretty soon I will lay off the "As a Rip van Winkle returnee to your country, what I notice is...." approach. But I have to say that it is striking to come back -- from the world of controlled media and not-always-accurate "official truth" in China -- and see the world's most mature democracy, informed by the world's dominant media system, at a time of perceived economic crisis and under brand new political leadership, getting tied up by manufactured misinformation. No matter what party you belong to, you can't think this is a sign of health for the Republic.

Interesting Tom Geoghegan interview re single-payer health care

For reasons explained several times in the past six weeks (here, here, and here), I really hope my long-time friend Tom Geoghegan can win next month's special election for the Congressional seat from the Fifth District of Illinois. This is no slight on any of the other candidates in the race. I know very little about them or the politics of the district. But I know enough about Geoghegan, based on decades of friendship starting when we were teenagers, to be 100% sure that he would bring an unusual level of honesty, intelligence, humor, and again honesty to national politics. I am saying honesty twice because I mean both the personal-probity and the plain-speaking variety.

Anecdote I just remembered: the first time I heard the name "Barack Obama" was from Geoghegan. He was visiting our house in Washington in the early 2000s, after Obama had made it into the Illinois State Senate and then lost his 2000 race for Congress against Bobby Rush, and before (I think) Obama's anti-Iraq-war speech of late 2002. "Watch this guy," Tom told my wife and me. He knew Obama from labor-organizing work on the South Side, since Geoghegan had spent much of his career representing dislocated workers in that area. "He can be our Lincoln." I thought: Yeah, yeah.

Now, back to Tom Geoghegan's honesty: His recent half-hour TV interview with Jeff Berkowitz, available on Geoghegan's campaign web site here and shown below, is a good illustration. You don't want to miss the host's unintentionally campy welcome to the program, 56 seconds into the clip. "Berkowitz is my name. Politics is our game." But the part worth studying is from 2:15 through about minute 10, when Geoghegan unashamedly argues in favor of a single-payer health coverage plan. And after that, he argues with similar directness for "soak the rich" progressive income-tax rates and nationalizing the failed banks -- or "the Greenspan plan," as we now know it.

  
If I were on Geoghegan's policy team, I'd be suggesting that when making the case for single-payer, he spend less time talking about Europeans and more talking about the success of VA hospitals in the US. (Phillip Longman's classic article on the VA as health-care model is here, and subsequent book here. For another time, my own recent experience with an extremely top-of-the-the-line doctor who told me how much simpler his practice would be if he could handle all his patients with the minimum of paperwork, bureaucracy, and insurance-driven hassle of his practice at the VA.) Still, it's impressive to watch a politician clearly explain why it would be cheaper and better to get rid of the massive insurance-company bureaucracy.

So whether you're interested in Chicago politics, health-care policy, or the process of making "daring" points on TV, this interview has its rewards. More about this interview, plus general campaign info, from one of Geoghegan's neighbors and supporters at the GSpot blog, here.